Browsing by Author "Yildirim, T"

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    Increased vitamin D binding protein levels are associated with irritable bowel syndrome
    Börekci, E; Kiliç, M; Ozan, Z; Börekci, H; Yildirim, T; Göçmen, Y; Bas, H
    Objectives: There is no reliable and valid biomarker to identify Irritable bowel syndrome (IBS) and its subtypes. The aim of this study is to explore potential serum biomarkers that may be associated with IBS subtypes, particularly in the vitamin D pathway. Methods: The study population comprised 75 IBS patients and 79 controls. Patients divided into IBS subtypes. Routine biochemical parameters, 25-OH-vitamin D, vitamin D binding protein (VDBP) and vitamin D receptor (VDR) serum levels were compared between IBS subtypes and controls. Factors related to IBS subtypes were examined by multivariate logistic regression analysis. Results: Vitamin D levels were lower; VDBP and VDR were higher in all IBS patients than in controls (p<0.001; 0.047 and 0.029, respectively). According to logistic regression analysis, VDBP was a disease-related parameter as much as vitamin D in all IBS subtypes. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were higher especially in diarrhea-dominant IBS (IBS-D) (p=0.041; 0.046) and vitamin B12 were significantly lower in constipation-dominant IBS (IBS-C) (p=0.001). Conclusions: Increased VDBP levels were associated with all IBS subtypes. Patients, especially in IBS-D, had higher serum levels of VDBP, CRP and ESR. Vitamin B12 deficiency, which we consider as a result of the disease, was more common in IBS-C.
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    The increase of neuropathic symptoms in diabetic patients is related with osteopenia
    Börekci, E; Kara, A; Kiliç, M; Tanik, N; Ozan, ZT; Yildirim, T; Aral, Y
    Purpose To investigate the relationship between the intensity of neuropathic pain and the severity of osteopenia in type 2 diabetic patients with painful diabetic peripheral neuropathy (painful DPN). Methods In 220 patients with type 2 diabetes included in the screening, the presence of neuropathic pain was evaluated using the Douleur Neuropathique 4 Questions (DN4) scoring system. One hundred forty-five patients with painful DPN were identified and included in the study. Socio-demographic and laboratory evaluations were made and bone mineral density (BMD) of these patients was evaluated by the dual-energy x-ray absorptiometry (DEXA) method. Results There was a significant correlation between the neuropathic pain score and the total T scores of the lumbar spine and femur in patients with painful DPN. According to the regression analysis (standard coefficients), the DN4 score (0.498); the level of vitamin D (- 0.246) and the female sex (0.236) for the lumbar spine region; age (0.387); DN4 score (0.261); and vitamin D level (- 0.155) for the femur region were independently influencing factors on the development of osteoporosis. When osteoporosis (T score <= - 2.5) of the lumbar spine was analyzed by binary logistic regression, the risk of osteoporosis in women was 4.4 times higher, and the risk increased with increasing DN4 score. Conclusion The increase of neuropathic symptoms in patients with DPN is an effective and important factor in the development of diabetic osteopenia.
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    The effect of hyperglycemic peak induced by oral glucose tolerance test on the oxidant and antioxidant levels
    Yildirim, T; Göçmen, Y; Ozan, ZT; Börekçi, E; Turan, E; Aral, Y
    Background/aim: The possibility of adverse effects of the oral glucose tolerance test (OGTF) carried out for the screening of gestational diabetes among pregnant women and fetuses is a frequently discussed topic. The purpose of this study was to investigate the effects of the hyperglycemia peak during OGTT on the levels of oxidants and antioxidants in the body. Materials and methods: Eighty individuals who applied to the Outpatient Clinic with suspected diabetes and OGTT indication were included in the study. Glucose, total oxidant capacity status (TOS), total antioxidant capacity (TAS), superoxide dismutase (SOD), and lipid hydroperoxide (LOOH) levels were tested on blood samples collected from these individuals at 0, 60, and 120 min during the OGTT carried out with 75 g of glucose. Oxidative stress index (OSI) was calculated as the ratio of TOS to TAS. Results: While the oxidative parameters TOS and LOOH were significantly increased at 60. min of OGTT, only LOOH was significantly increased at 120. min of OGTT. Significant decreases in antioxidative parameters (TAS, SOD) were observed at 60. and 120. min of the OGTT and OSI was significantly increased at 60. and 120. min of the OGTT. Conclusion: Oxidative stress parameters were increased and antioxidative parameters were decreased during the OGTT. However, more extended studies are required to determine the effects of the increased oxidative stress on pregnant women and fetuses.
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    Urinary HSP70 improves diagnostic accuracy for urinary tract infection in children: UTILISE study
    Yilmaz, A; Afonso, AC; Akil, I; Aksu, B; Alpay, H; Atmis, B; Aydog, O; Bayram, MT; Bilge, I; Bulut, IK; Buyukkaragoz, B; Comak, E; Demir, BK; Dincel, N; Donmez, O; Durmus, MA; Dursun, H; Dusunsel, R; Duzova, A; Ertan, P; Gedikbasi, A; Goknar, N; Guven, S; Hacihamdioglu, D; Jankauskiene, A; Kalyoncu, M; Kavukcu, S; Kenan, BU; Kucuk, N; Kural, B; Montini, G; Morello, W; Nayir, A; Obrycki, L; Omer, B; Ozdemir, EM; Ozkayin, N; Paripovic, D; Pehlivanoglu, C; Saygili, S; Schaefer, S; Sonmez, F; Tabel, Y; Tas, N; Tasdemir, M; Teixeira, A; Tekcan, D; Tulpar, S; Turkkan, ON; Uysal, B; Uysalol, M; Vaiciuniene, D; Yavuz, S; Yel, S; Yildirim, T; Yildirim, ZY; Yildiz, N; Yuksel, S; Yurtseven, E; Schaefer, F; Topaloglu, R; Bayazit, AK; Litwin, M
    Background The accuracy of conventional urinalysis in diagnosing urinary tract infection (UTI) in children is limited, leading to unnecessary antibiotic exposure in a large fraction of patients. Urinary heat shock protein 70 (uHSP70) is a novel marker of acute urinary tract inflammation. We explored the added value of uHSP70 in discriminating UTI from other infections and conditions confused with UTI. Methods A total of 802 children from 37 pediatric centers in seven countries participated in the study. Patients diagnosed with UTI (n = 191), non-UTI infections (n = 178), contaminated urine samples (n = 50), asymptomatic bacteriuria (n = 26), and healthy controls (n = 75) were enrolled. Urine and serum levels of HSP70 were measured at presentation in all patients and after resolution of the infection in patients with confirmed UTI. Results Urinary (u)HSP70 was selectively elevated in children with UTI as compared to all other conditions (p < 0.0001). uHSP70 predicted UTI with 89% sensitivity and 82% specificity (AUC = 0.934). Among the 265 patients with suspected UTI, the uHSP70 > 48 ng/mL criterion identified the 172 children with subsequently confirmed UTI with 90% sensitivity and 82% specificity (AUC = 0.862), exceeding the individual diagnostic accuracy of leukocyturia, nitrite, and leukocyte esterase positivity. uHSP70 had completely normalized by the end of antibiotic therapy in the UTI patients. Serum HSP70 was not predictive. Conclusions Urine HSP70 is a novel non-invasive marker of UTI that improves the diagnostic accuracy of conventional urinalysis. We estimate that rapid urine HSP70 screening could spare empiric antibiotic administration in up to 80% of children with suspected UTI.
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    The relationship between urine heat shock protein 70 and congenital anomalies of the kidney and urinary tract: UTILISE study
    Aksu, B; Afonso, AC; Akil, I; Alpay, H; Atmis, B; Aydog, O; Bakkaloglu, S; Bayazit, AK; Bayram, MT; Bilge, I; Bulut, IK; Cetinkaya, APG; Comak, E; Demir, BK; Dincel, N; Donmez, O; Durmus, MA; Dursun, H; Dusunsel, R; Duzova, A; Ertan, P; Gedikbasi, A; Goknar, N; Guven, S; Hacihamdioglu, D; Jankauskiene, A; Kalyoncu, M; Kavukcu, S; Kenan, BU; Kucuk, N; Kural, B; Litwin, M; Montini, G; Morello, W; Obrycki, L; Omer, B; Ozdemir, EM; Ozkayin, N; Paripovic, D; Pehlivanoglu, C; Saygili, S; Schaefer, F; Schaefer, S; Sonmez, F; Tabel, Y; Tas, N; Tasdemir, M; Teixeira, A; Tekcan, D; Topaloglu, R; Tulpar, S; Turkkan, ON; Uysal, B; Uysalol, M; Vitkevic, R; Yavuz, S; Yel, S; Yildirim, T; Yildirim, ZY; Yildiz, N; Yuksel, S; Yurtseven, E; Yilmaz, A
    Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are defined as structural malformations of the kidney and/or urinary tract. Heat shock proteins (HSPs) are expressed in the kidney in response to cellular changes, such as thermal, hemodynamic, osmotic, inflammatory, and mechanical stresses. This study aimed to assess uHSP70 levels during acute urinary tract infections (UTI) and non-infection periods in patients with CAKUT, and to evaluate whether uHSP70 is elevated in CAKUT subtypes. Methods: Among patients with CAKUT, 89 patients with UTI (CAKUT-A), 111 without UTI (CAKUT-B), and 74 healthy children were included in the study. uHSP70 levels were measured using enzyme-linked immunosorbent assay (ELISA). Results: uHSP70 level was significantly higher in the CAKUT-A group than in the CAKUT-B and healthy control groups (p < 0.0001). Moreover, the level of uHSP70 was significantly higher in the CAKUT-B group than in the control group (p < 0.0001), but was not different between the CAKUT subtypes (p > 0.05). Conclusion: Urine HSP70 can also be used to predict UTI in patients with CAKUT. Moreover, uHSP70 levels were higher in children with CAKUT during the non-infectious period than in healthy controls. This suggests that children with CAKUT are at risk of chronic non-infectious damage.
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    URINARY HSP70 IMPROVES DIAGNOSTIC ACCURACY FOR URINARY TRACT INFECTION IN CHILDREN: UTILISE STUDY
    Yilmaz, A; Afonso, AC; Akil, I; Aksu, B; Alpay, H; Atmis, B; Aydog, O; Bayazit, AK; Bayram, MT; Bilge, I; Bulut, IK; Buyukkaragoz, B; Comak, E; Demir, BK; Dincel, N; Donmez, O; Durmus, MA; Dursun, H; Dusunsel, R; Duzova, A; Ertan, P; Gedikbasi, A; Goknar, N; Guven, S; Hacihamdioglu, D; Jankauskiene, A; Kalyoncu, M; Kavukcu, S; Kenan, BU; Kucuk, N; Kural, B; Litwin, M; Montini, G; Morello, W; Nayir, A; Obrycki, L; Omer, B; Ozdemir, EM; Ozkayin, N; Paripovic, D; Pehlivanoglu, C; Saygili, S; Schaefer, S; Sonmez, F; Tabel, Y; Tas, N; Tasdemir, M; Teixeira, A; Tekcan, D; Tulpar, S; Turkkan, ON; Uysal, B; Uysalol, M; Vaiciuniene, D; Yavuz, S; Yel, S; Yildirim, T; Yildirim, ZY; Yildiz, N; Yuksel, S; Yurtseven, E; Schaefer, F; Topaloglu, R
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    Urine soluble TLR4 levels may contribute to predict urinary tract infection in children: the UTILISE Study
    Aksu, B; Afonso, AC; Akil, I; Alpay, H; Atmis, B; Aydog, O; Bayazit, AK; Bayram, MT; Bilge, I; Bulut, IK; Buyukkaragoz, B; Comak, E; Demir, BK; Dincel, N; Donmez, O; Durmus, MA; Dursun, H; Dusunsel, R; Duzova, A; Ertan, P; Gedikbasi, A; Goknar, N; Guven, S; Hacihamdioglu, D; Jankauskiene, A; Kalyoncu, M; Kavukcu, S; Kenan, BU; Kucuk, N; Kural, B; Litwin, M; Montini, G; Morello, W; Obrycki, L; Omer, B; Oner, HA; Ozdemir, EM; Ozkayin, N; Paripovic, D; Pehlivanoglu, C; Saygili, S; Schaefer, F; Schaefer, S; Sonmez, F; Tabel, Y; Tas, N; Tasdemir, M; Teixeira, A; Tekcan, D; Topaloglu, R; Tulpar, S; Turkkan, ON; Uysal, B; Uysalol, M; Vitkevic, R; Yavuz, S; Yel, S; Yildirim, T; Yildirim, ZY; Yildiz, N; Yuksel, S; Yurtseven, E; Yilmaz, A
    Background One of the most common bacterial infections in childhood is urinary tract infection (UTI). Toll-like receptors (TLRs) contribute to immune response against UTI recognizing specific pathogenic agents. Our aim was to determine whether soluble TLR4 (sTLR4), soluble TLR5 (sTLR5) and interleukin 8 (IL-8) can be used as biomarkers to diagnose UTI. We also aimed to reveal the relationship between urine Heat Shock Protein 70 (uHSP70) and those biomarkers investigated in this study.Methods A total of 802 children from 37 centers participated in the study. The participants (n = 282) who did not meet the inclusion criteria were excluded from the study. The remaining 520 children, including 191 patients with UTI, 178 patients with non-UTI infections, 50 children with contaminated urine samples, 26 participants with asymptomatic bacteriuria and 75 healthy controls were included in the study. Urine and serum levels of sTLR4, sTLR5 and IL-8 were measured at presentation in all patients and after antibiotic treatment in patients with UTI.Results Urine sTLR4 was higher in the UTI group than in the other groups. UTI may be predicted using 1.28 ng/mL as cut-off for urine sTLR4 with 68% sensitivity and 65% specificity (AUC = 0.682). In the UTI group, urine sTLR4 levels were significantly higher in pyelonephritis than in cystitis (p < 0.0001). Post-treatment urine sTLR4 levels in the UTI group were significantly lower than pre-treatment values (p < 0.0001).Conclusions Urine sTLR4 may be used as a useful biomarker in predicting UTI and subsequent pyelonephritis in children with UTI.